Ensure your company is protected with the right software! // Aetna, the nation’s third-largest insurance provider with 23.1 million customers, is under fire from an investigation led by the California Insurance Commissioner, Dave Jones. While Group Health is already a stringent practice that requires adherence to several laws and regulations, one of Aetna’s reviewing physicians [...]
As a software provider who has been in the workers' compensation industry well over a decade, DataCare has been able to address several elements that tie into the compliance of performing business as a TPA, managed care company, or a self-insured corporation. Many of our clients requested information about the security and reliability of the Ahshay [...]
This letter is to address the impact of Senate Bill 1160 (or SB1160) pertaining to self-insureds, TPA’s or third-party-administrators, employers, and utilization review organizations across California. On September 30, 2016, SB1160 was signed by Governor Jerry Brown, which is set for implementation beginning the first of January in 2018. The result of this bill will [...]
Express authorizations can be performed faster and more easily with the use of drug formularies. The recent release of the California Drug Formulary uses a very objective language suitable for fully- or partially-automated approval of requests. For example, after entering a medication request in DataCare’s UR++ system, the system can easily determine if the request should [...]
It seems like every time you blink a regulatory body is introducing a new recommendation or final rule. Many healthcare organizations feel like they are on the losing end of a never-ending battle and dread every change that comes their way. However, being resourceful and creative you can find ways to see opportunities in these [...]